Florida leads nation in turning down Medicaid money

But state officials may not be accepting many accolades for this latest distinction. Florida leads the nation in turning down Medicaid funding from the federal government, according to a new report from the Robert Wood Johnson Foundation and the Urban Institute.

By refusing to expand Medicaid under the federal Affordable Care Act, Florida will lose out on $66.1 billion in federal funding over the next decade. Florida even edges out Texas, which comes in at a close second with $65.6 billion in lost federal funding.

It also means in 2016 some 1.1 million Floridians will go without health insurance who otherwise could be covered by Medicaid, the federal-state health care program for the poor and disabled. Texas holds the lead there with an estimated 1.5 million uninsured residents, according to the report.

Florida and Texas are the biggest players among the 24 states that have decided not to use the option under the federal health care law to expand Medicaid to residents earning up to 138 percent of the federal poverty level. Most of the states are led by Republicans who have been vocal critics of the ACA, otherwise known as Obamacare.

The 24 states will lose out on $423.6 billion in Medicaid funding from 2013 to 2022, according to the report. Hospitals in those states will lose $167.8 billion in reimbursements that were designed to offset Medicare and Medicaid cuts that were part of the ACA. Florida hospitals will lose $22.6 billion through 2022.

There is also a “jobs” element. The report says if the 24 states expanded their Medicaid program it could result in an additional 172,400 jobs in 2015.

Medicaid is a program that requires a state match in funding. But under the ACA, the terms are very generous to the states. For the first three years of the expansion, the federal government will pay 100 percent of the costs. After that states must pay a portion — although it’s relatively small — of the annual costs.

In Florida’s case, the state would have to come up with $5.4 billion through 2022 in order to secure the $66.1 billion in federal funding.

Gov. Scott originally opposed the Medicaid expansion but reversed his position in 2013, although the expansion failed because of strong opposition from the Florida House. Opponents, including House Speaker Will Weatherford, R-Wesley Chapel, argued that although the funding offer appears attractive, there is no guarantee in the long term that the federal government will keep its commitment.

In the 2014 session, there was no real effort to expand Medicaid. But as Scott heads to his re-election bid in November, the former health care company executive reiterated his support for Medicaid expansion in a recent interview with the Tampa Bay Times. He has said he will support expansion as long as the federal government is paying the entire cost.

“While they spend 100 percent, I’m not going to stand in the way of the federal government doing something,” Scott told the newspaper. “What I’m not willing to do is put Florida taxpayers on the hook. . . . I’ve been very consistent and let’s all remember that Obamacare is an absolute bad bill for patients, for families, for employers, for employees.”

Democrats, who support the expansion, say they will make it a political issue this fall.

“We’ve gotten used to Rick Scott not following through, or flip-flopping, or pleading the fifth, or going to bat for special interests rather than struggling Floridians,” said House Democratic leader Perry Thurston, who is running for attorney general. “But with almost a million Floridians being denied basic access to health care, we simply cannot be silent.”

WINNER OF THE WEEK: Bill Galvano. The Bradenton senator quickly and successfully guided a congressional redistricting plan through the Senate during a five-day special session. Although the plan ran into opposition from Democrats and will face a court test, it could resolve a legal challenge over the validity of the 2012 congressional districts.

LOSER OF THE WEEK: Rick Scott. Over the governor’s objections, a judge ruled that Google and Yahoo must disclose who established several email accounts that were used by the governor’s staff. A lawyer suing Scott over a property dispute in Tallahassee says there is evidence that the private accounts may have been used for public business. Scott’s lawyers say the accounts were not used for public business.

QUOTE OF THE WEEK: “Hopefully we won’t become the pot capital of the world,” former Gov. Jeb Bush said, underscoring his strong opposition to a November ballot initiative that would allow the use of medical marijuana in Florida.

Lloyd Dunkelberger

Lloyd Dunkelberger is the Htpolitics.com Capital Bureau Chief.
He can be reached by email or call 850 556-3542.
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Last modified: August 15, 2014
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